Individual
JOHN SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9812 N 7TH ST, SUITE 7, PHOENIX, AZ 85020-1763
(602) 714-6783
Mailing address
9812 N 7TH ST, SUITE 7, PHOENIX, AZ 85020-1763
(602) 714-6783
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27081
AZ
207RB0002X
Obesity Medicine (Internal Medicine) Physician
27081
AZ
207RC0000X
Cardiovascular Disease Physician
27081
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060049547
RAILROAD MEDICARE
AZ
05
—
445470
—
AZ
01
—
WCSKQ
SUN HEALTH GROUP #
AZ
Enumeration date
08/09/2005
Last updated
10/24/2014
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